myocardial infarction

Classification of MICan be subcategorized by anatomy and clinical diagnosis information:1-Anatomic:Transmural and subendocardial 2-Diagnostic:ST elevations (STEMI) and non (NSTEMI).

 Risk factors for AMI: (modifiable) o High Blood Pressure

o High Triglyceride and cholesterolo Obesity and physical in activity

o Diabetes or High Blood Sugaro Excessive intake and saturated fats,

carbohydrates and salt. o Stresso Drugso smoking

(Non modifiable)• Age> 45 y• Gender: men are more

susceptible than predominant women• Family history.

Causes of AMI:

Bad Cholesterol, also called low density lipoprotein(LDL)

Saturated Fats Trans Fat

Signs of AMI:anxietycoughdizzinessfast heart rateheaviness in or across the chestpain in the chest, back, jaw, and other areas of the upper body

shortness of breathsweatingNausea and vomiting

Symptoms in some women may differ from those usually in men e.g many women have predominant symptoms of heartburn , malaise, heart beat abnormalitiesCough, loss appetite, ignoring such symptoms may cause treatment delays more damage heart tissue.

EPIDEMIOLOGY MI are the leading cause of death in the US , affecting one in five men and one in six women.

450,000 people in the US die from coronary disease each year

Incidence rates increase with age as do mortality rates due to infarction.

The survival rate for those hospitalized due to MI has reached approximately 95% .This is the result of advancements made in model medical technology.

pathophysiology

• Ischemic develops when there is an increased oxygen demand or decreased supply of oxygen .• Ischemic can develop within 10 sec

and if it lasts longer than 20 min , irreversible cell and death occur.• Myocardial cell death begins at the

endocardium. The area must distal to the arterial blood supply.

As vessel occlusion continous cell death spreads to the myocardium and evantually to the epicardium Severity of MI depends on three factors: level of occlusion length of time of

occlusion presence or absence of

collateral circulation

Complications:

Depends on the size, location, duration of lesions.Within minutes to 3 days:• Arrhythmia• Cardiac shock• Thrombotic complication• Rupture of the heart

Complications3 to 14 days:• Acute fibrinous or

hemorrhage precarditis over infarct area .

After weeks or months:• Chronic heart failure• Cardiac aneurysm, which may

rupture producing hemopericardium and death

diagnostic methods include:

troponin test – to check for heart damage

electrocardiogram – to measure the heart’s electrical activity

stress test – to check how your heart reacts to certain

situations, such as exercise.

Blood test X- ray Ejection fraction Creatine

phosphatase elevated for first hours

MANAGEMENTAnalgesicsThrombolytic therapyAnticoagulant and antiplatelet medications

Other medications such as ( beta adrenergic blocking agent) and Diazepam.

Treatment

• The immediate goal for any AMI is to restore normal coronary blood flow to vessels and salvage myocardium • There are a variety of myocardial and

medical therapies to treat a MI.

General treatment for the MI patient

• Morphine• Oxygen• Nitroglycerin• Aspirin

Get regular medical checkup Control your blood pressure Check your cholesterol Do not smoke Excercise regularly Maintain in healthy weight Manage stress

Prevention

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